Abstract
Background: There is an evident change in the colorectal cancer demographic over the period. This change is more marked in the age distribution and location of the tumor. It has practical implications, in regards to develop cancer awareness programs and screening protocols. Keeping in view that Pakistan is one of the countries with a high number of the young population this study is carried out to make a comparative analysis of this trend in our population. Material and methods: Colorectal cancer patients presented in Sindh Institute of urology and transplantation from January 2011 till December 2020 was reviewed retrospectively. All patients were divided into two groups, Group A young age population and Group B old age population. Subgroup analysis of study period was performed to check the progressive change in the trend of stage and clinical characteristics of colorectal cancer patients. Data reviewed from the patient’s files and collected as per Proforma requirement. Result: Total of 612 patients with colorectal cancer presented between 2011 till 2020.Among these patients 243 (39.7%) presented between January 2011 till December 2015. Patients age 50 years and younger were 410 (66.8%). Results showed a statistically significant association between and patient’s age and location of tumor such that left-sided colonic cancer and rectal cancer were more common in the young population. Subgroup analysis according to the study period showed that there is a change in the trend of disease presentation. Right-sided colonic cancer presentation decreased in the younger population over the period while simultaneously left-sided colonic cancer and rectal cancer presentation increased. Conclusion: The incidence of left-sided colonic and rectal cancer has been increased in the younger population over the specified period while there was no association between right-sided colon cancer and age noticed.
Highlights
There is an evident change in the colorectal cancer demographic over the period
With regards to the age distribution of Colorectal Cancer (CRC), between 2009 and 2013 colorectal cancer incidence decreased by 4.6% per year in individuals aged 65 years and older and increased in individuals younger than 50 years by 1.6% per year [1, 2, 3]
We found that the incidence is shifted from 35% to 64.9% for left-sided colonic cancer while for rectal cancer the incidence is shifted from 37.2% to 62.6%
Summary
There is an evident change in the colorectal cancer demographic over the period This change is more marked in the age distribution and location of the tumor. With regards to the age distribution of CRC, between 2009 and 2013 colorectal cancer incidence decreased by 4.6% per year in individuals aged 65 years and older and increased in individuals younger than 50 years by 1.6% per year [1, 2, 3]. This decrease in incidence among individuals older than 55 years of age is largely attributed to populationbased CRC screening recommendations in place since the 1980s [1, 2, 3, 4]. For colon cancer, the adjusted incidence rates increased annually over roughly the past four decades by 2.4% in those aged 20 to years, by 1.0% in those aged to years, and by 1.3% in those aged to 49 years; for rectal cancer, the adjusted incidence rates have increased by 3.2% in those age 20-39 years and by 2.3% in those age 4049 years [4]
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